Sexuality and reproductive health

Maternal morbidity and mortality is worse in Bangladesh because of low usage of maternal healthcare. An attempt, based on Andersen’s health seeking behavior model and Bangladesh Demographic and Health Survey-2007 data, has been made to investigate maternal healthcare utilization by ever married women in Bangladesh. For showing geographic variation and pattern of maternal healthcare utilization across districts several maps have been made by using GIS. For finding significant determinants of maternal healthcare utilization, four dependent variables (antenatal care, place of delivery, assistance during delivery and postnatal care) were considered; and logistic regression models were estimated for those four dependent variables. Results reveal that education level, household wealth index and place of residence are significant determinant for raising utilization of all four types of maternal healthcare. In addition, age at childbirth has statistically significant impact on antenatal care. For bringing up utilization of maternal healthcare, some long term interventions, such as providing education to girls, should be emphasized. Also, short term intervention as community education for married women, about symptoms of complications during pregnancy and at delivery, about importance of treatment should be implemented. For raising mat

This paper is based on the results of a study was implemented in 2009 by the IPSS–National Economics University of Vietnam, funded by Save Children US, The objective of the paper is to determine student teachers’ knowledge, attitude and practice relating to reproductive health (RH) and HIV/AIDS prevention. The study was conducted at Ministry of Education and Training and at four pedagogical institutions of Vietnam. The target population group includes national education officials, university officials and student teachers. The study utilized a combination of a desk review, qualitative and qualitative survey. Data analysed revealed that most student teachers had good basic knowledge but lacked key information and held mixed attitudes about RH and HIV/AIDS prevention. Student teachers are still keeping traditional point of view, were hesitant to share information on RH and HIV/AIDS prevention with other people. College’s or university’s courses and health care facilities were not frequently mentioned as information sources. Some recommendations were suggested on advocating for RH and HIV/AIDS prevention education in all pedagogical colleges and universities, on providing student teachers about in-depth information and skills on RH and HIV/AIDS prevention and on eliminating attitudes of stigma toward people living with HIV.

Multilevel modeling is commonly used to assess the influence of community-level variables on demographic and health outcomes, yet these methods have rarely been applied at the couple-level. We conduct multilevel modeling of data from 238 couples who participated in the 2005 Cebu Longitudinal Health and Nutrition Survey in the Philippines to assess the individual-, partner-, and couple-level influences on men’s and women’s family planning knowledge. Preliminary findings indicate that 17% of the total variance in family planning knowledge across participants was between couples. Individual-level (e.g., female gender and higher educational attainment) and couple-level variables (e.g., relationship duration, partnership status, and greater church participation by female partner) were significantly associated with greater knowledge of family planning methods, as compared to other couples. Subsequent analyses will assess additional individual and couple-level covariates and cross-level interactions. Preliminary results indicate that knowledge of family planning methods are influenced by individual, partner, and relationship characteristics.

Problems with reproductive health data in non-Western settings are widely noted and have been the focus of innovative methodological work. Collection of improved data on contraceptive use and abortion generally involves methods for distancing the interviewer from the respondent through forms of self-administered questionnaires (ACASI, etc.). We discuss an alternative approach which breaks from the “stranger interviewer norm." We present data from a unique experimental design recently fielded in the Dominican Republic levels of familiarity linking interviewers and respondents are randomly varied and test how this variation alters responses. Initial evidence suggests that contraceptive use estimates obtained by more traditional, stranger interviewers in our sample resemble estimates obtained by the DHS. Estimates obtained by local interviewers however are far lower. Our findings suggest that levels of familiarity strongly affect how contraceptive use data are reported by respondents. Further analysis is focused on indirect methods to validate the widely varying reports.

In response to demographic challenges and shifting public health priorities, many countries in sub-Saharan Africa, aided by international donors, have attempted in recent years to reposition family planning (RFP). However, the lack of a tool to assess progress has hindered their efforts. Recognizing this need, Futures Group participated in a collaborative project to develop a framework of indicators that assess change in the RFP environment. Since September 2011, Futures Group has applied the framework in eight countries in Francophone West Africa and is currently drafting individual country reports to describe the status of RFP as measured by these indicators. This paper outlines the process Futures Group used in the countries to gain acceptance of the framework: identifying key stakeholders from government, technical, and financial groups; nongovernmental organizations; and civil society and tapping their expertise through meetings and interviews. Countries are now able to assess progress toward RFP and have begun to see the need to incorporate policy indicators in their health information systems. The initiative suggests that the countries face similar challenges and can draw on some common actions to reposition family planning in order to meet women’s unmet need for safe, effective, modern contraception.

The goal of this paper is to better appreciate how estimates of the maternal mortality ratio (MMR) are related to estimates of fertility and female reproductive age mortality and how changes in the MMR can be placed within the broader context of recent changes in fertility and adult mortality. To achieve this goal an alternative expression for the maternal mortality ratio, that incorporates measures of fertility and mortality, will be presented. This expression will also be used as a tool for comparing estimates of MMRs produced by the United Nations interagency working group with estimates from different data sources to better understand why there are large discrepancies in estimates for individual countries. Special consideration is given to the set of countries that have experienced large changes in female reproductive age mortality due to the rise in AIDS mortality.

Along with socio-economic development, adolescents and youth in Vietnam are more actively and early engaging in sexual practice, including premarital sex. This practice produces bad consequence as the fact that Vietnam now is one of the countries having highest abortion rate, for both women and adolescents/youth, in the world. The National Survey Assessment on Vietnamese Youth (SAVY) can provide a comprehensive picture of premarital sex among adolescents/youth as well as possible factors affecting this practice. Research findings reveal that 9.3 percent of adolescent and youth have had premarital sex. Various individual demographic, socio-economic, family and community factors possibly having influence, both good and bad, on shaping sexual attitude and practice of adolescents and youth are examined. Statistically significant relationships between the examined factors and sexual practice may give suggestion to policy makers and programs to address reproductive health information and services needed for this vulnerable group of population.

This paper explores domestic violence against women inflicted by husbands and its effect on reproductive health outcomes among ever married women of Bangladesh using the nationally representative 2007 Bangladesh Demographic and Health Survey data. Three indicators: ‘childbearing before age 18’, ‘pregnancy termination’ and ‘having symptoms of sexually transmitted diseases or sexually transmitted infections’ were considered as the outcome variables. Both bivariate and multivariate statistical techniques were applied in analysing the data. Findings revealed that, overall 53.2% of the women ever experienced any domestic violence inflicted by their husbands. The multivariate analyses revealed that, physical violence only significantly (p<0.01) increased the risk of childbearing before age 18 (OR=1.28, 95% CI=1.09-1.58). Both physical and sexual violence were associated with significantly (p<0.01) higher risks of pregnancy termination (OR=1.35, 95% CI=1.06-1.71) and having symptoms of sexually transmitted diseases or infections (OR=2.80, 95% CI=2.14-3.66). Programs to reduce poor reproductive health outcomes such as increased risk of teenage pregnancies, higher risk of pregnancy termination and elevated risk of sexually transmitted diseases among women must address domestic violence as part of effective prevention strategies.

Under the male-dominated socio-cultural setting that persists in Thailand, it can be argued that women living with HIV/AIDS (WLHA) are at greater risk of gender-based violence than non-infected women. In addition, the patriarchal Thai norms blind people in society – including the victims – to fully seeing and acknowledging the problem of gender-based violence and the extra vulnerability of WLHA. Thus, a significant portion of society accepts gender-based violence as part of the cultural context and as nothing out of the ordinary in a woman’s daily life or something that needs to be changed. The 5 years project entitled Support for HIV-affected Women from Gender-based Violence (SHAW) implemented by Raks Thai Foundation with funding from UNWOMEN is an initiative to address HIV/AIDS related violence against HIV/AIDS affected women in Thailand at the community level. A mixture of quantitative and qualitative data collection techniques are used to assess the Project achievements after completion of implementation. The assessment was conducted during February 2012. This paper focuses on HIV/AIDS affected women as peer leaders to help other HIV-effected women to combat gender-based violence. In particular, it emphasizes the outcomes of SHAW project which suggest changes in ability to provide assistance and manage problems of violence

Issues about women, particularly utilisation of maternal health care services have been given increasing attention in Ghana. With maternal mortality ratio estimated to be 451 deaths per 100,000 live births, the country declared maternal mortality as a national emergency in 2008 in order to meet the MDG’s pertaining to maternal health and to reduce child mortality in Ghana. This study investigates the physical accessibility, socioeconomic and demographic characteristics and utilisation of delivery health care services among a sample of 413,034 women aged 12-49 years in Ghana who had live births 12 months before the 2003 CWIQ Survey. Both bivariate and multivariate statistical techniques are employed in the analysis of the data. The study among other things shows that place of residence, level of education and means of transportation predicts use of maternal health care services. For example, women residing in rural areas are less likely (OR= 0.83) to receive professional assistance during delivery than women residing in urban areas. Policy on maternal health care services utilisation needs to focus more on rural, less educated women and means of transportation to health facilities.